ATI CAPSTONE PHARMACOLOGY 2 EXAM

ATI CAPSTONE PHARMACOLOGY 2 EXAM A nurse is teaching a client who is to start taking methyldopa for the treatment of hypertension. Which of the following information should the nurse include in the teaching? • The medication can cause dizziness- Methyldopa can cause orthostatic hypotension and dizziness when the client is changing position. Therefore, the nurse should instruct the client to change position slowly while taking methyldopa. • This medication can cause insomnia • Expect to experience depression while taking this medication A nurse is providing discharge instructions to a client who has a new prescription for omeprazole for the treatment of GERD. Which of the following statements by the client indicates an understanding of the teaching? • This medication kiss the bacteria in my stomach. • This medication neutralizes stomach acid • This medication coats the lining of my stomach. • This medication reduces stomach acid – GERD is a condition in which gastric acids reflux from the stomach to the esophagus. Omeprazole is a proton inhibitor that suppresses the production of gastric acid. The medication reduces baseline acid levels and blocks production of nearly all stimulated acid production within 2 hrs of an oral dose. A nurse is caring for a client who requires a transfusion of one unit of packed RBCs. The nurse receives the following prescription: Diphenhydramine 50 mg by mouth once, one hour prior to transfusion. The nurse should identify this as which of the following types of prescription? • PRN prescription • Standing prescription • Stat prescription • Single prescription A nurse is providing teaching to a client who has prostate cancer and a new prescription for leuprolide. The nurse should explain to the client that leuprolide treats prostate cancer by which of the following actions? • Leuprolide decreases the production of testosterone -- Leuprolide treats prostate cancer by decreasing the production of testosterone. It causes an initial increase in testosterone, which results in desensitization and a subsequent decrease in testosterone production. • Leuprolide kills cells at all stages of cellular division • Leuprolide increases estrogen levels in your body to counteract the cancer cells. A nurse is reviewing the medical record of a client who has asthma and takes albuterol. Which of the following findings should the nurse identify as an adverse effect of albuterol? • Fasting blood glucose 68 mg/dL • Heart rate 110/min – Above the expected reference rage of 60 to 100/min. Albuterol can cause tachycardia because it increases the excitability of the beta 1 receptors in the heart. More serious cardiac effects include palpitations, chest pain, hypertension, and arrhythmia. The nurse should report these findings to the provider. A nurse is caring for a client who has a systemic fungal infection and is receiving IV amphotericin B deoxycholate. During previous infusions, the client developed a fever and chills. Which of the following actions should the nurse take? • Apply a warming blanket prior to administration • Infuse the medication over 1 hr. • Administer diphenhydramine prior to administration—Infusion reactions often occur following the administration of amphotericin B. The nurse should administer an antipyretic, corticosteroid, antihistamine, or antiemetic prior to administration of amphotericin B to minimize these effects • Monitor vital signs once per hour following administration. A nurse is assessing a client who is in preterm labor and is receiving magnesium sulfate via continuous IV infusion. Which of the followings should the nurse identify as the priority? • Flushing • Deep tendon reflexes 1+ -- When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is deep tendon reflexes 1+ , which indicates a depressed CNS and possible magnesium sulfate toxicity. • Respiratory rate 22/min A nurse is preparing to administer medications to a client who has type 1 diabetes mellitus. The client takes lispro insulin and has a new prescription for pramlintide. Which of the following actions should the nurse take? • Monitor the client for weight gain • Monitor for hypoglycemia for 3 hrs. after pramlintide administration – The nurse should monitor the client for manifestations of hypoglycemia for 3 hrs. after administering pramlintide. Pramlintide does not cause hypoglycemia. However, when combined with insulin, hypoglycemia can occur within 3 hors. Of administration. The client should take pramlintide before meals along with lispro insulin. • Inject the pramlintide in the client’s upper arm • Administer pramlintide 30 min prior to a meal. A nurse is caring for a client who reports using the herbal medication garlic along with prescribed warfarin. The nurse should identify that which of the following is a potential adverse effect of taking both of these products concurrently? • Altered renal perfusion • Elevated blood pressure • Increased ecchymosis- The nurse should identify that ecchymosis occurs when there is bleeding under the skin. Additionally, the nurse should recognize that, garlic has anti-platelets effects that can result in bleeding. When taken concurrently with an anticoagulant, such as warfarin, there is an increased risk for bleeding. A nurse is providing teaching t a client who is starting to take aspirin. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication? • Black, tarry stools- A client who takes aspirin can have an increased risk for bleeding because aspirin suppresses platelet aggregation. The nurse should instruct the client to monitor for and report indications of bleeding, such as bruising, petechiae, and blood in stools or urine. • Nystagmus • Dry mouth A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory tests should the nurse monitor to detect an adverse effect of the medication? • B-type natriuretic peptide (BNP) • Creatinine - The nurse should monitor creatinine, BUN and urine output for a client who is receiving gentamicin, and aminoglycoside antibiotic. Gentamicin is an aminoglycoside that has both nephrotoxic and ototoxic adverse effects. • Amylase level A nurse is assessing a client who has diabetes insipidus and is starting intranasal desmopressin. Which of the following findings should indicate to the nurse that medication is effective? • The client has clear mucus • The client’s 24 hr urine output is 1.256 mL - Desmopressin is effective for the treatment of diabetes insipidus, a disorder of the posterior pituitary gland in which large amount of dilute urine are produced due to a deficiency in vasopressin. The action of desmopressin causes reabsorption of water and a decrease in urine volume. A urine output of 1.256 mL over 24 hr is within the expected reference range and indicates the medication is effective. A nurse is assessing a client who has a prescription for haloperidol 0.5 mg PO three times daily. The medication administration record shows that the client received 5 mg per dose on the previous day. Which of the following manifestations is the nurse’s priority to assess? • Muscle stiffness - The nurse should recognize tha the greatest risk to the client is developing neuroleptic malignant syndrome, and adverse reaction to haloperidol that is potentially fatal if not treated promptly. Manifestations of neuroleptic malignant syndrome include extreme muscle stiffness, sudden increase in temperature, diaphoresis, dysrhythmias, and fluctuations in blood pressure. • Blurred vision • Constipation A nurse is assessing a client who received ondansetron 1 hr. ago. Which of the following findigns should the nurse identify as a therapeutic effect of the medication? • Decreased pain • Suppressed emesis – Ondansetron suppresses nausea and vomiting induced by chemotherapy, anesthesia, radiation therapy, or morning sickness by blocking serotonin receptors in the upper GI tract and in the CNS • Supresed cough • Decreased fever A nurse is caring for a client who is receiving morphine. Which of the following assessments should the nurse perform first? • Apical heart rate • Blood pressure • Respiratory rate – When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority assessment is respiratory rate. The nurse should withhold the morphine and notify the provider if the respiratory rate is less than 12/min. A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the following medications should the nurse expect the provider to prescribe? • Naloxone • Bupropion • Methadone • Chlordiazepoxide – The nurse should expect the provider to prescribe chlordiazepoxide, a benzodiazepine, to a client who is at risk for alcohol withdrawal delirium. Chlordiazepoxide can prevent the client form experiencing seizures as a result of withdrawal and lessen the effects of withdrawal. A nurse is caring for an older adult client who is confirmed positive for HIV and will begin medication therapy. Which of the following instructions should the nurse give the client? • You will be prescribed more than one medication to fight the virus.